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Esketamine Nasal Spray [Spravato]

Royal North Shore Hospital · FDA-approved active Small molecule

Esketamine is an NMDA receptor antagonist that rapidly blocks glutamate signaling in the brain to produce fast-acting antidepressant effects.

Esketamine is an NMDA receptor antagonist that rapidly blocks glutamate signaling in the brain to produce fast-acting antidepressant effects. Used for Treatment-resistant depression in adults, Major depressive disorder with acute suicidal ideation or behavior.

At a glance

Generic nameEsketamine Nasal Spray [Spravato]
Also known asSpravato
SponsorRoyal North Shore Hospital
Drug classNMDA receptor antagonist
TargetNMDA receptor
ModalitySmall molecule
Therapeutic areaPsychiatry
PhaseFDA-approved

Mechanism of action

Esketamine is the S-enantiomer of ketamine and works by antagonizing N-methyl-D-aspartate (NMDA) receptors, which are glutamate-gated ion channels. This blockade leads to rapid disinhibition of downstream neural circuits and increased synaptic plasticity, producing antidepressant effects within hours to days rather than weeks. The nasal spray formulation allows for rapid systemic absorption and CNS penetration.

Approved indications

Common side effects

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